Carter BloodCare Service Manual
1.1 History
1.2 Mission Statement
1.3 Vision Statement
1.4 Accreditation
1.5 Department Descriptions and Contact Directory
1.6 Forms
Bedford Organizational Chart
Tyler Organizational Chart
2.1 Quality Policy Statement
2.2 Quarantine Notices
2.2.1 Quarantine/Lookback Notices
2.3 Recall/Market Withdrawal Notices
2.4 Quality Assurance Consultation Services
2.5 Forms
QAF403.01 Suspected Component Contamination Notification
QAF601.01A Component Recall/Market Withdrawal Notification
QAF601.01B Quarantine-Release Notification
QAF602.01 Consignee Notification Record
QAF602.01.01 Reactive Non-Discriminate Multiplex HIV-1/HCV Assay Notification
3.1 Disaster Plan
3.1.1 Coordinating the Local Blood Supply During Disasters
3.1.1.1 Purpose
3.1.1.2 Introduction
3.1.2 Glossary of Terms
3.1.3 Carter BloodCare’s Responsibilities
3.1.4 Customer’s Responsibilities
3.1.4.1 Pre-Disaster Preparation Checklist
3.1.4.2 During the Disaster
3.1.4.3 Working with the Media
3.1.5 Biological Attack Response Process
3.1.6 Regulatory Concerns
3.1.7 Handling Internal Disasters at Carter BloodCare
3.2 Blood Service Agreement Statement
3.3 Finance and Billing Policies
3.3.1 Third Party Payments
3.3.2 Payment Options
3.3.3 Billing Periods
3.3.4 Payment Terms
3.3.5 Billing Transaction Document
3.3.6 Weekly Invoices
3.3.7 Credit Memo
3.3.8 Debit Memo
3.3.9 Return Slip
3.3.10 Transfer Slip
3.3.11 Pack List
3.3.12 Financial Questions
3.4 Notification of Policy Changes
3.5 Forms
Weekly Invoice
Credit Memo
Debit Memo
Return Slip
Transfer Slip
Pack List
4.1 Reporting Adverse Reactions
4.1.1 Definition
4.1.2 Types of Adverse Transfusion Reactions
4.1.3 Transfusion Related Fatalities
4.1.4 Reporting a Suspected Transfusion Reaction
4.1.5 Recommended Actions if a Suspected Transfusion Reaction Occurs
4.1.6 To Initiate a Transfusion Reaction Investigation Work-up
4.1.7 Carter BloodCare Transfusion Reaction Investigation
4.2 Suspected Cases of Transfusion-Associated Infection
4.2.1 Notification to Carter BloodCare
4.2.2 Other Notification
4.2.3 Carter BloodCare Investigation
4.3 Reporting Transfusion Related Lung Injury (TRALI)
4.4 Forms
RTF195.03B, Transfusion Reaction Investigation Final Report
RTF215.01A, Transfusion Reaction Investigation
RTF195.03A, Transfusion Reaction Preliminary Report
DNF106.02A, Report of Suspected Transfusion Associated Infection
DNF106.30A, Report of Transfusion-Related Acute Lung Injury Investigation
DNF106.30D; Suspected TRALI Investigation Summary
5.1 General Customer Complaints, Comments, and Customer Incidents
5.2 Customer Surveys
5.3 Forms
QSF702.01, Customer Incident
6.1 Circular of Information
6.2 Supplies
7.1 Neighborhood Donor Centers
7.2 Blood Drive Information
7.3 Health Fairs
8.1 Autologous Donations
8.1.1 Autologous Blood Donation Request
8.1.2 Autologous Donation Criteria
8.1.3 Autologous Donation Scheduling
8.1.4 Facility Notification of Autologous Donation
8.1.5 Autologous Labeling
8.1.6 Low Weight/Volume Autologous Red Cells
8.1.7 Autologous Unit Testing
8.1.8 Special Considerations
8.1.9 Policy for Freezing Autologous Red Blood Cells
8.2 Restricted Donations
8.3 Therapeutic Phlebotomy
8.3.1 Therapeutic Donor Request
8.3.2 Therapeutic Donation Criteria
8.3.3 Therapeutic Phlebotomy Scheduling
8.3.4 Associated Fees
8.3.5 Unit Disposition
8.4 Hereditary Hemochromatosis (HH) and Low Testosterone (LOT) Therapy
8.4.1 Donor Meets Eligibility Criteria and has a Draw Frequency of >8 Weeks
8.4.2 Donor Does not meet Eligibility Criteria &/or Requires a Draw Frequency of <8 weeks
8.5 Forms
8.5.1 Autologous Forms
SDF801.01, Autologous Blood Donation Request
SDF801.01B, Autologous Worksheet
SDF801.01C, Donation Attempt Notification Letter to Hospital
SDF802.01A, Autologous Blood with Abnormal Test Result Notification
SDF801.01E, Frozen Autologous Red Blood Cell - Management Record
DCL255, Autologous Tie Tag (double sided)
Autologous Donation Information
8.5.2 Restricted, Therapeutic, HH and TRT Forms
DCL500, Restricted Donation tie tag (orange)
SDF801.03 Therapeutic Donor Request
Therapeutic Donation Information Sheet
DNF104.35C Enrollment/Prescription for No-Fee Phlebotomy for Hereditary Hemochromatosis (HH) Patients Only
DNF104.35D Enrollment/Prescription for Phlebotomy Due to Testosterone Replacement Therapy (TRT)
9.1 Components Provided
9.2 Component Manipulation Services
9.3 Donor Unit Testing
9.3.1 Routine Testing
9.3.2 Other Tests Performed as Indicated
9.4 Testing and Labeling
9.5 Placing an Order
9.6 Specimen Collection and Preparation
9.7 Unacceptable Specimens
9.8 Specimen Shipping
9.8.1 Sample Shipping Requirements
9.8.2 Sample Delivery
9.9 Test Turn-Around-Time (TAT)
9.10 Test Cancellation
9.11 Results and Reports
9.12 Forms
Remote Testing Requisition Form (4 part/carbonless)
Carter BloodCare Platelet Apheresis Tag
9.13 Acceptable Plasma Examples
11.1 Placing an Order
11.1.1 Phoned Orders
11.1.2 Faxed Orders
11.1.3 iWebb Orders
11.2 Order Confirmation
11.3 Order Status
11.3.1 STAT
11.3.2 Urgent
11.3.3 ASAP (As Soon as Possible)
11.3.4 Routine
11.3.5 Hospital to Hospital Transfer
11.4 Delivery Response Times
11.5 Filling an Order
11.6 Delivery Options
11.7 Product Substitution
11.8 Emergency Release
11.9 Inventory Management
11.10 Order Documentation
11.11 Return Policy and Quarantine Requests
11.12 Forms
DPF200.20A, Fax order and Inventory Form
DPF300.03, Hospital Report of Returned Blood Components
DPF200.05, Hand Ship Ticket
DPF300.03A, Return of Blood For Investigation
DPF400.20A, Quarantine Request Facsimile
DPF400.20B, Quarantine Release Request Facsimile
DPF400.20C; Notification/Quarantine Request Fax
12.1 General Information for Patient/Reference Testing Services
12.1.1 Contract
12.1.2 Requisitions
12.1.3 Specimen Collection and Preparation
12.1.4 Sample Shipping Requirements
12.1.5 Unacceptable Specimens
12.1.6 Available Tests
12.1.7 Test Priority (Does Not Include Delivery Time)
12.1.8 Test Cancellation
12.1.9 Results, Reports, Requests for Quarantine, and Requests for Historical Patient Antibody Testing Information
12.1.10 Emergency Release of Untested Components
12.1.11 Notification of Pending Test Completion
12.2 Reference Testing Services – Red Blood Cells
12.2.1 Serological Testing
12.2.2 Red Blood Cell Antigen Screening
12.2.3 Red Blood Cell Crossmatch Services
12.3 Reference Testing Services – Platelets
12.3.1 HLA matching
12.3.2 Platelet Antibody Screening and Crossmatching
12.3.3 Requesting Platelet Testing Services
12.3.4 Sample Requirements for Platelet Testing Services
12.3.5 Platelet Labeling
12.4 Reference Testing Services – Molecular Testing Services
12.5 Reference Testing Services – Preventative Maintenance Services
12.6 Reference Testing Services – Cellular Therapy Services
12.7 Granulocyte Product Order
12.8 Example Reports
12.9 Forms
APL100, Apheresis Product Tag
APL100, Crossmatched Apheresis Product Tag
RAF601.00, Request for Product Quarantine, Records Audit and Data Entry
RTF101.01A, Reference and Transfusion Services Request Form
RTF103.01A, Reference and Transfusion Service Patient Historical Record - Bedford
RTF120.11A, Request for Product Quarantine, Discard, or Retrieval
RTF120.11D Reference and Transfusion Suspected Component Contamination Notification
RTF214.01, Uncrossmatched Product Release
RTF214.03, Untested Product Release form
RTL214.01, Emergency Release Uncrossmatched Blood Label
RTL214.03A, Previous Donation Results Label
RTL214.03B, Testing Not Performed Label
RTL422.01, HLA Matched Tie Tag
Non-Crossmatch Compatibility Tag
Crossmatch Compatibility Tag
RTL207.01A, Confirmed Antigen Typing
RTL207.01C, Molecular Matched Antigen Typing
RTF101.01F Flow Cytometry Cellular Therapy Request
RTF205.13A Granulocyte Product Order & Physician Release Form
13.1 Therapeutic Apheresis Services
13.2 Diseases which may be treated by Apheresis
13.3 Contract/Privileges
13.4 Emergency Privileges
13.5 Granulocyte Orders
14.1 Overview
14.2 Contract/Privileges
14.3 Emergency Privileges
14.4 Product Collection, Processing, and Infusion
14.4.1 Collections of Peripheral Blood Stem Cells
14.4.2 Institutional Responsibilities for PBSC Collection
14.4.3 Donor Prescreen for PBSC and Marrow Collection
14.4.4 Assisting with Surgical Harvest of Bone Marrow
14.4.5 Processing and Cryopreservation
14.4.6 Product Storage
14.4.7 Thawing and Infusion
14.5 Forms
HPF170.06, Infectious Disease Tube Collection Form
15.1 Suggested Services
16.1 Carter BloodCare Tours
16.2 Hospital Forums
16.3 Staff In-services
16.4 External Audits Performed for Transfusion Services
16.5 Known Samples Provided
16.6 Reimbursement Review for Blood Product Coding
16.7 Transfusion Medicine Fellowship Rotation
16.8 Resident Pathologist Blood Center Rotation
16.9 Medical Student Blood Center Community visits